24 specialized coder jobs found

Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. Job Specifications and Core Competencies: Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

Physician Coder I The Certified Coder I performs functions of coding diagnosis and procedures from outpatient center/clinic records utilizing International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes. (Potential Remote) Typical Duties: Assigns codes to diagnosis and procedures of outpatient records, including clinics, Urgent Care and Emergency room, utilizing ICD and CPT codes in accordance with ICD Coding Guidelines, CPT Coding Guidelines, American Hospital Association (AHA) Coding Clinics and the JPS Outpatient Coding Policy and Procedures. These charts are typically less than one day stays and are of low to medium clinical complexity of service requiring knowledge of anatomy, physiology and basic pharmacology. Ensures codes are assigned accurately and sequenced correctly ensuring reimbursement is appropriate in accordance with government, insurance, and/or other payer regulations to include the coding of diagnoses and procedures and...

About the Job: The Medial Records Coder is responsible for assigning ICD-10-PCS diagnostic and procedural codes to patient accounts codes and abstracts hospital medical records for maintenance of disease indices, internal and external reporting, research, compliance with federal, state and other regulatory agencies, and for billing and reimbursement. Uses various coding manuals and computer encoder. Confirms appropriate DRG assignments. Safeguards and preserves the confidentiality of patient identifiable information in accordance with hospital and department policy. Resolves error reports associated with billing process, identifies and reports error patterns, and, when necessary, assists in design and implementation of workflow changes to reduce billing errors. Roles and Responsibilities: ESSENTIAL FUNCTIONS: Assigns appropriate codes using International Classification of Disease system (ICD-10) and/or Current Procedural Terminology (CPT) for diagnosis, procedures, and services....

Join Our Team!!!Trustpoint Rehabilitation Hospital is a premier inpatient facility specializing in the treatment of stroke, brain and spinal cord injuries, orthopedic trauma, and other complex medical conditions. We are proud to be one of the few rehabilitation hospitals in the region that also provides care for pediatric patients, offering specialized services tailored to the unique needs of children and their families. Our mission is to provide compassionate, individualized care that empowers patients—of all ages—to regain independence and achieve their best outcomes.About Trustpoint Rehabilitation Hospital of LubbockLocated at 4302 Princeton Street in Lubbock, TX, Trustpoint is a 93-bed inpatient rehabilitation hospital specializing in adult and pediatric care. We are proud to be ranked in the Top 10% nationally for rehabilitative care and have earned The Joint Commission's Brain Injury, Stroke, and Spinal Cord Rehabilitation Certification.We are seeking a Coder to join our team...

Overview Hospital Coder - Inpatient Rehabilitation - Ernest Health Ernest Health is a network of rehabilitation and long-term acute care hospitals. Ernest Health hospitals provide specialized medical and rehabilitative services to patients recovering from disabilities caused by injuries or illnesses, or from chronic or complex medical conditions. Our hospitals are located in Arizona, California, Colorado, Idaho, Indiana, Montana, New Mexico, Ohio, South Carolina, Texas, Utah, Wisconsin, and Wyoming. CODER We're looking for professionals with a passion for coding, attention to detail, and with excellent communication skills. The Coder is an integral part of the hospital's team, working closely with Physicians and Director of Patient Outcomes (DPO). Successful candidates will enjoy working both independently and collaborating with a team of clinical professionals. Key responsibilities include: Provide expertise in the areas of coding and classification...

Hospital Coder - Inpatient Rehabilitation - Ernest HealthErnest Health is a network of rehabilitation and long-term acute care hospitals. Ernest Health hospitals provide specialized medical and rehabilitative services to patients recovering from disabilities caused by injuries or illnesses, or from chronic or complex medical conditions. Our hospitals are located in Arizona, California, Colorado, Idaho, Indiana, Montana, New Mexico, Ohio, South Carolina, Texas, Utah, Wisconsin, and Wyoming.We're looking for professionals with a passion for coding, attention to detail, and with excellent communication skills.The Coder is an integral part of the hospital's team, working closely with Physicians and Director of Patient Outcomes (DPO).Successful candidates will enjoy working both independently and collaborating with a team of clinical professionals.Key responsibilities include:Provide expertise in the areas of coding and classification systems to healthcare providers throughout our...

We are hiring a part-time Medical Coder to assign procedure and diagnosis codes for insurance billing, review claims data, research and correspond with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. Responsibilities Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims. Adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-9 and ICD-10. Answer coding questions. Review clinical documentation to ensure it meets level of CPT codes and ICD-10 codes. Perform related duties, as requested. Uphold the Organization's...

Company Overview Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children's Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions. Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare...

About Us Community Health Choice, Inc. (Community) is a non‑profit managed care organization licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with programs including the Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women; the Children’s Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR; Health Insurance Marketplace Plans offering individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions; and the Community Health Choice HMO D‑SNP, a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid. Improving members’ experiences is at the heart of every Community...

Who We Are JPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people. Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time. Why JPS? We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is...

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits,...

Summary About the Position: This is an open continuous announcement. Multiple vacancies exist and may be filled from this announcement at any of the locations listed. We accept applications on an ongoing basis; qualified applicants will be considered as vacancies become available. Salary negotiation may be available for those candidates who are new to Federal service. This is a Direct Hire Solicitation Responsibilities Perform retrospective audits of diagnoses, E/M levels, procedures, and documentation to identify inaccurately coded services and ensure regulatory compliance. Review medical records, analyze coding accuracy trends, prepare finding reports, and coordinate results with leadership to drive performance improvement. Use encounter audits to identify operational and regulatory issues, ensures complete data capture, and support development of compliance plans. Develop and deliver one-on-one and group training on documentation and coding requirements; updates clinical...

Summary About the Position: This is an open continuous announcement. Multiple vacancies exist and may be filled from this announcement at any of the locations listed. We accept applications on an ongoing basis; qualified applicants will be considered as vacancies become available. Salary negotiation may be available for those candidates who are new to Federal service. This is a Direct Hire Solicitation Learn more about this agency Duties Help Perform retrospective audits of diagnoses, E/M levels, procedures, and documentation to identify inaccurately coded services and ensure regulatory compliance. Review medical records, analyze coding accuracy trends, prepare finding reports, and coordinate results with leadership to drive performance improvement. Use encounter audits to identify operational and regulatory issues, ensures complete data capture, and support development of compliance plans. Develop and deliver one-on-one and group training on...

Job Description Job Description Job Posting: Medical Biller/Coder Clarius Medical Group PLLC – Sugar Land, TX (On-site)About Us Clarius Medical Group PLLC is a dynamic and patient-centered internal medicine and geriatrics practice. We aim to provide top-tier primary care across various settings including clinics, hospitals, and specialized facilities. Based in Sugar Land and extending our services throughout the Greater Houston area, we are committed to employing advanced EHR systems and interactive tools such as eClinicalWorks and Healow to enhance patient care and outcome measures. Position Summary We have an exciting opportunity for a Full-Time Medical Biller/Coder to join our administrative team. This position requires a professional who is well-versed in both front-end and back-end billing operations, applicable in outpatient or multi-site healthcare environments. The role involves close collaboration with healthcare providers, the practice management team, and external...

Billing Coder IIIInform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology.Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform. Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike. Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel...

Inpatient Coder III Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services. Ben Taub Hospital (Level 1 Trauma Center) and Lyndon B. Johnson Hospital (Level 3 Trauma Center) anchor Harris Health's robust network of 39 clinics, health centers, specialty locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from...

Job Description Job Description Role Description This is a full-time on-site role for a Medical Billing Specialist. As a Medical Billing Specialist, you will play a crucial role in ensuring the financial health of our customers. We seek individuals with a strong work ethic, excellent problem-solving skills, and a genuine passion for medical billing. Your responsibilities will include managing insurance communications, reconciling insurance EOBs and payments, maintaining patient confidentiality, managing denials, utilizing ICD-10 codes, verifying insurance information, and working with commercial and government insurance providers. Due to the nature of the healthcare industry, a high degree of professionalism and attention to detail is essential.   Responsibilities Function as a subject matter expert in support of other billing team members. Demonstrate a good understanding of payer benefits requirements, claims status, submissions of claims, insurance follow-up, payment...

Analyze patient charts, physician notes and discharge summaries Ensure documentation is complete and accurate before coding Translate diagnoses and procedures into standardized codes using: ICD-10-CM (diagnoses) CPT (procedures) HCPCS (supplies/services) Make sure codes correctly represent services provided Follow healthcare laws and regulations (HIPAA, Medicare/Medicaid guidelines) Company Policies Prevent coding errors that could lead to claim denials or audits Stay updated on coding changes and updates Work with billing teams to submit coded claims to insurance companies Verify claim accuracy to ensure proper reimbursement Fix rejected or denied claims by reviewing and correcting codes Communicate with healthcare providers and insurance companies Protect sensitive patient information Follow strict privacy and data security standards Clarify documentation with physicians when needed Collaborate with billing and administrative teams Regularly update knowledge of...

Remote Certified CoderAltegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in:CMS HCC Risk AdjustmentHEDISMedical Record Reviews (Accreditation)And moreThese are remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines).Responsibilities:Abstract pertinent information from patient medical records. Assign appropriate...

Job Description Job Description Certified Coder | $27.00 per Hour | Monday – Friday, 8:00 AM – 5:00 PM | Hybrid | Contract What Matters Most Competitive Pay of $27.00 per hour Schedule: Monday – Friday, 8:00 AM – 5:00 PM Hybrid work schedule Contract opportunity with a leading healthcare organization Weekly Pay with direct deposit or pay card When you work through Team1Medical, you are eligible to enroll in dental, vision and medical insurance as well as 401K, direct deposit and our referral bonus program Job Description We are seeking an experienced Certified Coder with a strong background in outpatient Neurosurgery and Evaluation & Management (E/M) coding. This position is responsible for reviewing clinical documentation and diagnostic results to accurately assign ICD-10-CM, CPT-4 codes, and modifiers for billing, reporting, research, and regulatory compliance. The ideal candidate will have experience coding Neurology services for physicians, strong...

Inpatient Medical Biller Nexus Health Systems is seeking an experienced Inpatient Medical Biller to join our Central Business Office. This role is responsible for the accurate and timely billing of inpatient hospital claims to government and commercial payers. We are looking for a highly detail-oriented professional with experience in hospital billing, electronic claim submission, and navigating payer-specific billing requirements. This is a medical billing positionnot a collections role. The ideal candidate has hands-on experience submitting claims through a clearinghouse, understands hospital billing codes and claim requirements, and has successfully billed both in-state and out-of-state payers. Essential Responsibilities Prepare, review, and submit accurate inpatient hospital claims for Medicare, Medicaid, managed care, and commercial insurance payers. Submit claims electronically through a clearinghouse and monitor claim acceptance, edits, and rejections. Review...

Inpatient Medical Biller Nexus Health Systems is seeking an experienced Inpatient Medical Biller to join our Central Business Office. This role is responsible for the accurate and timely billing of inpatient hospital claims to government and commercial payers. We are looking for a highly detail-oriented professional with experience in hospital billing, electronic claim submission, and navigating payer-specific billing requirements. This is a medical billing positionnot a collections role. The ideal candidate has hands-on experience submitting claims through a clearinghouse, understands hospital billing codes and claim requirements, and has successfully billed both in-state and out-of-state payers. Essential Responsibilities Prepare, review, and submit accurate inpatient hospital claims for Medicare, Medicaid, managed care, and commercial insurance payers. Submit claims electronically through a clearinghouse and monitor claim acceptance, edits, and rejections. Review patient...

Job DescriptionJob DescriptionWho is Athra Systems?Athra Systems / Crosstown Mental Health is a dynamic and forward-thinking organization dedicated to offering a wide array of behavioral health services and solutions.We pride ourselves on fostering a supportive and inclusive work environment where every team member can thrive and contribute to our collective success.Previously, a private pay company, we are now expanding to accept insurance to help more people, and the whole company is quickly adapting.Position Overview :We are seeking a Medical Biller with comprehensive knowledge of behavioral health insurance billing.The Medical Biller will be responsible for the accurate and timely billing of all professional and facility services claims, ensuring all billing activities comply with applicable regulations.In this role, you will work closely with patients, insurance companies, and healthcare providers to resolve billing issues.If you have expertise in every step of the billing...

Job DescriptionJob DescriptionQMACS, Inc., a well-established medical billing company located in Richardson, Texas, has an opening for an experienced emergency department coder.The right candidate should be able to code both professional and facility charts; adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-10, HCPCS and ACEP coding and reporting.The ideal candidates should have the ability to work within a team environment to ensure optimal revenue attainment and complete compliance with governmental and private payor requirements.AAPC and / or AHIMA Medical Coding Certification is required.Experience is preferred.RequirementsExperience coding Emergency Department chartsKnowledge of HITECH & HIPAA compliance rules and regulations requiredAbility to work well with Microsoft Office suite of products, particularly ExcelAbility to work in and / or familiarization with a variety of EHR products is a plusKnowledge of facility AND...